Factors associated with uptake of abdominal aortic aneurysm screening by older men living in Scotland

Abstract Background High uptake is essential for abdominal aortic aneurysm screening to be effective. The aim of this study was to assess the influence of rurality, social deprivation, clinic type, distance to screening clinic and season on uptake of abdominal aortic aneurysm screening by men aged 6...

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Bibliographic Details
Published in:European journal of public health 2019-11, Vol.29 (Supplement_4)
Main Authors: Kasengele, K, Crilly, M A, Nimmo, F
Format: Article
Language:English
Subjects:
Abdomen
Aneurysms
Aorta
Aortic aneurysms
Clinics
Confidence intervals
Deprivation
Indexes
Men
Nurses
Older people
Public health
Rural areas
Rurality
Screening
Statistical analysis
Statistics
Urban areas
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Summary:Abstract Background High uptake is essential for abdominal aortic aneurysm screening to be effective. The aim of this study was to assess the influence of rurality, social deprivation, clinic type, distance to screening clinic and season on uptake of abdominal aortic aneurysm screening by men aged 65 years. Methods Screening in Grampian was undertaken by four trained nurses in eight community and two hospital clinics. Men aged 65 years were invited for screening by post, with two further reminders for non–responders. Abdominal aortic aneurysm screening data are stored on the national ‘call-recall database’. The Scottish ‘postcode directory’ was used to allocate all invited men a deprivation index (Scottish Index of Multiple Deprivation), Scottish urban/rural category and distance to clinic. Multivariate logistic analysis was conducted using IBM-SPSS Statistics (version 24). Results A total of 12,281 men were invited for screening between 1st November 2013 to 31 January 2017. Overall uptake was 87 per cent. The detection rate was 12.0 per 1000 men screen (95 per cent c.i. 9.9 to 14.0). The prevalence of abdominal aortic aneurysms increased with increasing deprivation, whereas uptake declined with increasing levels deprivation. On multivariable analysis a one point increase in SIMD decile was independently associated with a 1.10 (95 per cent confidence interval 1.08 to 1.12) increase in the relative odds of being screened. Uptake was consistently lower in the ‘large urban area’ of Aberdeen city compared to the other five Scottish urban/rural categories. Uptake was lower at community-based clinics. Season and distance-to-clinic were not independently associated with uptake. Conclusions Social deprivation, urban/rural residence and clinic type were found to be independently associated with the uptake of abdominal aortic aneurysm screening among men. Key messages A more targeted approach is needed in the large urban area of Aberdeen because the impact of multiple social deprivation on uptake was found to be more substantial here. Encouraging high uptake remains essential for abdominal aortic aneurysm screening to be effective.
ISSN:1101-1262
1464-360X
DOI:10.1093/eurpub/ckz185.303